14
OU-HCOM
by Jack Barkin
Chapter National Representative
We all start off similarly when it comes to palpation. We think it is a skill we should be good at because we have been touching and feeling things our whole lives. Then we go to medical school, where we meet more experienced peers and physicians who can put their hands on a persons head, turn to their colleague and after a few seconds say “this person’s sacrum is tight, I think more on the left than on the right…what do you think?” Perplexed, disbelieving, confounded, bamboozled, tricked, pranked, and finally curious were a few of the thoughts that ran through my head the first time I went to our school’s palpation club and saw a second year palpate. Physicians are even more impressive. The amount of information they glean from what seems to be so little is, as I’m sure many of you have experienced, incredible. A year later I still find myself being awed from time to time, but not nearly as much as in the past. I’ve come to realize that, like every learned skill, proper palpation and OMT takes practice. This reality is one that some people have a hard time grasping and the frustration incurred is usually taken out on osteopathy as a whole. “I don’t buy it”, “No way they can feel that” are just a couple of the expressions I’ve heard fellow classmates use when a physician is telling a story that necessitates an understanding of palpation (i.e. performing OMT on a gall bladder to fix 20 years of abdominal pain). The fact of the matter is that the argument “I can’t feel it, so no one can, so the treatments I’m learning might as well be a course on the placebo effect” aren’t exactly fair. My approach when I talk with those who are frustrated with their OMM experience is talk about basketball. OMT and palpation by extension is a lot like any sport that requires skill. The first time I picked up a basketball and started dribbling it, I was bad. But I was also five and I was a beginner. Now a person may argue, “well I’ve been touching things my whole life so why can’t I feel when the muscle relaxes? Is this really even doing anything? Why is it that when I palpate a person I can’t feel where tension is coming from in places further from where I’m touching?” The first time you picked up a basketball could you make a jump shot? Could you dribble with both hands, between the legs, or behind the back? Could you dunk?? No, of course you couldn’t (and if you’re like me you still can’t do that stuff), but you practiced, you got a little stronger, you unknowingly developed better cortical connections from your brain to your hands that told you how best to contact the ball. You stood at the foul line for hours working on a skill until you could do it consistently. Doctors and student doctors who are able to feel things others cannot, aren’t magicians, they are people who have ten to twenty years of experience feeling and treating the body. So when they are treating an irritated gallbladder or fixing years of dysfunction in a relatively short amount of time they are doing the OMT equivalent of a between the legs dunk. As I said in the beginning, our palpatory abilities all start off similarly. We think we should be able to feel everything when we can’t because we’ve never truly tried to palpate anything our entire life. That’s okay though. It’s okay that we aren’t good at feeling things but the associated attitude of disbelief that lingers in some students is something that I think we can do something. I think it is something we can use to help our peers and incoming students develop a curiosity that will help refocus frustrations toward trying to better understand OMM rather than dismiss it. I hope all of you have a fantastic year. ❉
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Palpation: The skill no one wants to learn because we all think we know it